KEYNA OMENUKOR NPI 1215307715

NPI Information

  • NPI: 1215307715
  • Provider Name: KEYNA OMENUKOR
  • Classification: Nurse Practitioner - 363LF0000X
  • Specialization: Family
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 1675 REPUBLIC PKWY STE 190
    MESQUITE, TX
    ZIP 75150
  • Phone: (972) 576-7399

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NPI Details

Keyna Omenukor is a family nurse practitioner in Mesquite, TX with 8 years of experience. Keyna Omenukor NPI is 1215307715. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1675 REPUBLIC PKWY STE 190
MESQUITE, TX
ZIP 75150-902
Phone: (972) 576-7399
Fax: (972) 476-0006

The NPI 1215307715 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 9/28/2015 and was last updated on 10/2/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LP0808XNurse PractitionerPsychiatric/Mental Health0024286045VIRGINIANo
2363LP0808XNurse PractitionerPsychiatric/Mental HealthAP61500520WASHINGTONNo
3363LP0808XNurse PractitionerPsychiatric/Mental HealthAP128934TEXASNo
4363LF0000XNurse PractitionerFamilyAP128934TEXASYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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